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It's nearly Summertime here in New York City and our Board Certified Dermatologist, Cheryl Karcher sat down with THE AEDIT to discuss the difference between Freckles and Sun Spots. Here in Downtown Manhattan, we hear from patients all the time about their sun spot concerns. Read below about what you can do to protect and prevent sun damage, as well as the remedies that can help if you spot a sun spot!
What Are Freckles?
Freckles are small dark spots, usually less than 5mm in diameter, where the skin cells have produced extra pigmentation. Most freckles are uniform in color, but it varies depending on skin tone. They can be red, tan, light brown, dark brown, black, or any color that is darker than the person’s skin color. That is typically why people with pale skin have a more reddish hue to their freckles.
A person’s ability to make freckles is due to genetics. For instance, if your parents have freckles, it is likely that you will have freckles too. Although freckles are hereditary, they are activated by sun exposure. If someone that has the freckle gene (MC1R), they must spend time in the sun in order to produce freckles. A person without the freckles genes will not produce freckles regardless of if they are in the sun or not.
Freckles actually serve a purpose. In a way, they act like sun screens and are a natural way to block the UV rays from penetrating the deeper layers of the skin. They are not a sign of sun damage, but rather protect areas of the skin that are particularly sensitive to ultraviolet light. With that in mind, if you have a lot of freckles, that is a good indicator that you should be applying sunscreen regularly and generously to prevent sun damage.
What Are Sun Spots?
The quickest way to tell if a brown spot is a freckle or sun spot is that that sun spots are typically larger in size (.2-2.0 centimeters) and are most commonly found on the hands, face, shoulders, back, arms, and tops of feet. They are also more common with aging, which is why they're also called age spots, senile lentigines, and liver spots. They are larger because the involve multiple pigmented cells lumped together.
The good news about sun spots is that they are not always permanent. Sometimes they can fade if the sun is avoided for a long enough period of time. Prevention is always better than curing, though. Limiting sun exposure, using sunscreen liberally, and avoiding artificial tanning like sun beds, is recommended to avoid sun spots.
What's The Differences Between Freckles and Sun Spots?
While freckles are more visible against lighter skin types, they are actually linked to the same gene responsible for complexion. The MC1R gene not only controls the likelihood of freckles but also it is responsible for skin color and hair color, particularly for red hair. Similarly, people with lighter complexions are also most susceptible to develop sun spots. The key difference is that sun spots are more common among older populations and can start forming in the mid-thirties. With repeated sun exposure over years, the skin cells start to produce melanin, forming the sun spots.
Additionally, the lifespan of freckles and sun spots is different. Freckles typically fade away with age and even seasons whereas sun spots tend to stick around longer. Because of this, sun spots can require skin treatments for removal.
Are They Harmful?
Fortunately, neither freckles or sun spots are harmful. Even though they are benign, it is still important to monitor their appearance to make sure there are no irregularities or changes which could indicate malignant melanoma (skin cancer). Should you notice any changes, it is important to schedule a visit with your board-certified dermatologist to be on the safe side.
Removing Sun Spots
Should you have unwanted sun spots that have not gone away over time, in-office skin treatments like IPL , laser therapy, chemical peels, or micro needling and topical applications have proven to be effective in diminishing their appearance.
For in-office treatments, New York-based board-certified dermatologist Cheryl Karcher, MD recommends intense pulsed light treatment (IPL) or Cutera Excel V, a laser treatment the targets the pigment. “The Cutera Excel V," will target the individual sunspot," she says. "IPL can target the individual sunspot but can also do the entire face arms or legs. Both treatments have some downtime and the patient cannot get sun two weeks before the treatment or two weeks after the treatment.”
While over-the-counter skin care products and prescription topical remedies have worked for some, their results usually cannot match those of in-office treatments. If you would prefer to use a cream or lotion to treat age spots, see a board-certified dermatologist first. “Hydroquinone creams and creams with Kojic acid have been found very useful in feeding sun spots,” Dr. Cheryl Karcher says. “It can take a long time, but they can lighten the spots. Again, if a patient gets any sun on those spots it will take months for the spot to lighten.”
Each of these treatments vary in price and may require multiple sessions to see desired results. Regardless of which treatment you choose, age spots can reappear, so it is important to protect your skin from the sun. To properly protect your skin, choose a broad-spectrum sunscreen, which protects agains both UVA and UVB rays, that is water resistant and over SPF 30. Apply a liberal amount of lotion daily and re-apply every couple of hours to ensure you are fully protected.